This invention is in the field of medical devices and more specifically those devices provided to exchange a tubular spike from one bag of fluid to an adjacent bag of fluid. The device disclosed herein is particularly advantageous in changing a tubular spike from one peritoneal dialysis bag into an adjacent peritoneal dialysis bag while ensuring the connection remains sterile. Peritoneal dialysis takes advantage of the fact that the peritoneal cavity is covered by a peritoneal membrane (a thin shiny membrane covering the abdominal cavity) which can be used for transfer of body waste from the blood into the peritoneal fluid instilled into it. To perform peritoneal dialysis, a dialysis solution is placed within the abdominal cavity and left there for a period of time. During this time, molecules of waste particles from the blood diffuse across the peritoneal membrane into the fluid and the fluid is subsequently drained out and discarded with new fluid being put into the peritoneal cavity to begin the process anew.
The aforementioned process is relatively slow as compared to hemodialysis; however, with the advent of continuous peritoneal dialysis the previously described process becomes a much preferred and efficient method of treatment. In 1975, Popovich and Moncrief, described the exchange method of C.A.P.D. (continuous ambulatory peritoneal dialysis) in which two liters of fluid are placed in the abdomen and left to dwell for a period of four to eight hours. At the end of this time, the fluid is drained and two liters of new fluid is put back into the abdominal cavity. A modification of this procedure by Oreopoulos in 1977 included the use of peritoneal dialysis solution in two liter bags. The bags could then be rolled up (in the empty state) during the dwell time. These patients were amubulatory and required only one bag connection for both infusion and drainage of the fluid. C.A.P.D. has now expanded widely with over 5,000 patients in the United States now receiving this therapy for chronic renal failure. When the patient changes from the old bag to a new bag connected to the tubing inserted into the abdominal cavity, the patient must under sterile conditions remove the plastic spike from the bag that is to be discarded and sterilely place this spike into the new bag. The method now used calls for the patient to have enough strength to pull the spike out of the bag and insert it into the new bag without any deviation.
There are many advantages to C.A.P.D. For example, the patient is ambulatory, is extremely mobile and can travel virtually anyplace desired as long as the bags of fluid are taken with the patient. Further, C.A.P.D. can be performed by the patient without requiring the help of a partner. It is desirable to place a number of patients on C.A.P.D.; however, there are some limitations with the method of spike exchange now used. It has been shown that diabetics have an increased incidence of blindness and it is believed the blindness is hastened by hemodialysis. Thus, it is beneficial to place these patients on C.A.P.D. This is quite difficult because the patient cannot see well enough to make the exchanges under sterile conditions and the spike becomes contaminated resulting in the patient developing peritonitis. If a blind patient or a patient with limited muscle strength or dexterity is to be placed on C.A.P.D., a partner must be used and thus decreasing the true advantages of C.A.P.D. Therefore, it would be ideal to have a mechanism by which a person who is blind, has failing eyesight, has decreased manual dexterity or decreased strength in his hands could perform the exchange of the spike by himself. Disclosed herein is such a piece of equipment allowing the change of the tubing spike from the used bag to a new bag without contamination. The exchange can be done with minimal effort with someone who has decreased vision, blindness, decreased manual dexterity or extreme weakness of the hands.